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Common Physician Thought Distortions, Mental Filter and Dismissing the Positive

We are currently in a series reviewing the top thought distortions physicians display. They are not unique to the medical field by any means, but these are the ones that often are uncovered in coaching. Being able to identify them clearly, makes it malleable so you can decrease the unnecessary stress they brings with them. Last week we looked at all-or-nothing thinking and should statements, and today we will look at two closely related thought errors – dismissing the positives and mental filter. Both can lead to shame, regret, embarrassment, anxiety, defeat, and discouragement.



Mental Filter. This filter is when you are conditioned to strain out everything except the negative from your experiences. We know that what we focus on grows. We find ourselves magnifying the impact of negative situations and interactions.


Let’s look at a common one I see happens with evaluations. Let’s say the following are sentences from your 360 eval, and your overall score is 90th percentile.

“Dr. X is diligent and reliable.”

“Helped me during a complicated patient situation. I very much respect and appreciate Dr. X.”

“Team player.”

“Great leader!”

“Great clinical instincts, realized the urgency in a specific situation.”

“Relatable to patients and families.”

“Needs to be more organized.” 

“Cares about the staff.”

What do most of us zero in on? Yep. “Needs to be more organized.” The spiral may look something like, “I know I’m not organized. I wonder who said that. They probably think I’m not good enough to be here. I’ll never live up to the standard. I bet it’s when I had coffee stains all over my notecards. I can’t be in primary care being this disorganized. Oh, maybe it was that time x,y,z commented that my work was out of control...” And, off you spiral as it interferes with dinner and family time. Maybe it even affects your sleep.


Now there’s a whole lot to unpack with feedback. You can get a glimpse further into my take by clicking here.


But let’s focus in on the filter. How often do we think about all the positive comments or the overall fantastic score? Almost none. They have been sifted out of our area of conscious thought. If they seep into our conscious thought, we might think, “Well, yea, I was just doing my job.” As if the positives deserve no attention.


The way to lessen the stress is to become aware when you’re ruminating on a negative. Challenge yourself to give at least equal airtime to the positives. (Due to our built-in negativity bias, some recommend multiplying the time spent on the positives as far greater than the negative). Give yourself permission to learn and move on. By this, I mean reflecting instead of ruminating. Do you want to improve your organizational skills? What ideas do you want to try? Make a plan and leave the “who wrote it, what’s it based on, and labeling yourself a helpless cause” behind. If you don’t feel you’re disorganized or feel it’s a problem, you get to decide what you want to do or not. People have the right to see things differently than you. If it’s something your supervisor or advisor sees as a problem but you don’t, then you have a choice. Do you want to grow in that area because it’s vital to your career advancement, or do you want to let it go? Let them be wrong about you. Or perhaps internally (or out loud) agree to disagree.


Dismissing the positives. In this thought error, the established pattern closely resembles the mental filter. Not only do you fail to dwell on the positives, but you also actually dismiss them altogether. You label them false, flattery, or just the obligatory bread in the feedback sandwich, which holds no truth except the "negative meat".


Begin to think of when you’ve been complimented or received positive feedback. Actively look for how those could be true. Your brain likes to give you answers, and you will likely generate some data. Be intentional in asking yourself what is going well right now. When the first-order reflex answer you give yourself is “nothing,” think more broadly, be open, and dig deeper to see what is going well. You will begin to build up your belief with positive examples.


I like to think of the work as savoring, like savoring the first bite of a decadent dessert or your favorite drink. Dwell on the positives, accept them, enjoy them, and rest in them a bit. You earned it!  Celebrate the wins!!!


Next week, we will move into the assumption category of cognitive errors. 


Until then, have a joy-filled week!  Tonya

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